Nineteenth Century Medical Guide

Chapter 82 79. Salt is not just a condiment——Shoumeng LoveMIkeG Han Zong Jiageng (45)

The physiological structure of the appendix is ​​a narrow and long dead end, easy to get in and difficult to get out, which means that the ileocecal area will not be peaceful, and once it encounters traffic jams, problems will inevitably occur.

However, environmental factors only provide the conditions for the onset of the disease. It takes an opportunity to actually cause appendicitis, and the source of traffic congestion must be found to relieve it. Therefore, the appendix needs to be cut open and sectioned for inspection after surgery.

The most common cause of appendicitis is bezoar, which is usually caused by indigestion and constipation.However, the number of enemas performed by priests was considered outstanding in the 19th century when enemas were enjoyed, so the possibility of fecal stones is very low.Combined with the odd shape of the tail end, this piqued Carvey's interest and was why he wanted to do pathology.

But now it seems that the cause is clear in advance.As soon as Varela finished speaking, Carvey basically guessed the reason: roundworm appendicitis.

Roundworms are not a rare thing in modern times. They may be rare in cities, but they are still a common disease in vast rural areas and relatively backward areas.Roundworms like to bite internal organs, and they have a single tendon. The priest's appendix is ​​so long and narrow, it is a rare refuge. 【1】

"It's just a worm." Carvey stepped forward to pinch the appendix, took a pair of scissors, cut it from the broken end, and quickly pulled out a pink nematode with thin horizontal stripes, "Teacher, it should be a roundworm. "

"It turned out to be caused by bugs?"

"Ascaris. That's roundworm-associated appendicitis."

"How could roundworms get into that kind of place?"

"I'm afraid this is the 'Satan' that the priest is talking about."

In an era when we knew nothing about microbes, doctors knew a little about parasites, bugs that are visible to the naked eye.Of course, this kind of understanding only stays on the patient's symptoms. As for the daily habits and growth process of the worms, they still don't know anything. Even most doctors don't know how the roundworms come from.

Was it accidentally swallowed?

Or did it grow from swallowed eggs?
Or it is really that Satan deliberately placed them in the human body to destroy them, the Catholic believers.
Ignatz wasn't interested in bugs. He was interested in being right about his diagnosis of appendicitis.With this roundworm, the haze that he didn't show up yesterday was swept away: "Did the whole bug get into the appendix?"

"Yes, the worm is less than 18-19cm, because the priest's appendix is ​​too long, and he didn't pay attention when he cut it off." Carvey took a simple measurement of the roundworm and continued, "We didn't find any in the cecum during the operation. Other things, there is no edema in the intestinal wall, so it should be diagnosed as appendicitis."

"Haha, typical appendicitis!"

Ignatz further affirmed his point of view, and turned the output power to the maximum to the audience around him: "I have performed a total of 16 appendectomies, and the proportion of inflammation around the cecum is very small, only 2 For example, it can also be found in a large number of autopsies that the incidence of inflammation in the appendix is ​​much higher than that in the cecum.

Everyone needs to remember that if there is inflammation in the cecum, there is almost 100% problem with the appendix.Therefore, the conclusion of peri-appecal inflammation is unrealistic nonsense, without rigorous statistics, and no autopsy data to support it, it is as ridiculous as the abstinence operation they came up with. "【2】

This worm did give Ignatz a lot of courage, uncharacteristically daring to insist on a small number of appendicitis views.

And some viewers from Britain and France also have an open-minded attitude towards Ignatz's criticism.After all, the facts are in front of us. It is indeed biased to use a "pericecal inflammation" with a very low incidence rate to include "appendicitis" with a much higher incidence rate.

As for abstinence surgery, it may be related to the Catholic Church, so it is a matter of opinion. 【3】

It's a pity that it will take quite a while to overthrow the solidified medical theories, at least until the medical conference before meeting and exchanging saliva with those deadly enemies.

The final abdominal closure was done by Carvey and Herman, but Herman did more of it.

Carvey just helped him get started, set the position of the first stitch, and then threw all the needlework to him: "Usually you don't practice too much, so you should sew."

Herman smiled and said, "No way, I have a lot of chores to deal with, and I won't be able to take the lead during the autopsy."

Carvey is not a heartless person, he knows that these chores should be done by himself, but now he has become a master of obstetrics, and several caesarean section women need him to deal with.And Bergert and the others happened to be going back to school to attend the school celebration as outstanding graduates [4] these few days, so Herman had to pick up those chores.

Kavey also came through step by step from a young age, knowing that giving young people the necessary opportunities to practice mobile phones can help them build confidence, so that they will not panic too much in the face of upcoming opportunities and waste opportunities for no reason.

All Herman lacked was practice and a little initiative.

"Actually, I'm already very proficient at suturing the skin." Herman was doing the incision closure, gently passing the needle through the skin at the edge, and suddenly asked, "When will Dr. Carvey teach me to suture the intestinal tube?"

"After two days when Bergett and the others come back, the operation in the ward is almost done, let's go to the slaughterhouse together." Carvey suggested, "Mainly get some pig skin, pork and internal organs, which can help you practice suturing skills , and the price is not expensive."

With Kawei leading the practice, Herman has no reason to refuse.

Having been in the assistant position for many years, he knows how good Carvey's skills are.Not only is the eye accurate, the clamp is in place, the hand is also stable when suturing, and the speed is fast. A broken blood vessel can be solved in the blink of an eye.

Moreover, for complex intestines, fascia, skin, muscles, blood vessels and other surrounding tissues, Carvey chooses slightly different suturing methods, but he can switch freely during operation.Even a leading surgical figure like Ignatz needs to confirm the location first and conceive of the needle entry point, which is impossible to achieve this level.

Outsiders watched the excitement, and the audience couldn't see it clearly, but people from the same surgical team had surgery together, so how could they not know.

Herman understood this, and so did Ignatz and Shiels.It's just that one chose to turn a blind eye, while the other chose to resist.

Herman couldn't turn a blind eye, and wanted to resist like Hills.After all, I have worked under Ignatz for so many years, and I have worked hard without credit. If someone directly blocked the ascending channel, anyone would feel resentful.

But he still put his mind on it and chose to hug his thigh.

The reason still had to be attributed to the cesarean section last night, Ignatz was not present, Hills was in no state, and only Herman saw Kavey's every move in his eyes.Under the circumstance that the operation may fail at any time, in order to ensure the tight suturing of the uterus, Carvey seems to have taken out some of the strength of the bottom of the box.

Whether it is speed or precision, it is one or two grades higher than this appendicitis, far exceeding Ignatz's usual level.

There are generally only two ways to obtain this kind of technology that is far beyond normal people, massive surgical practice and talent.Carvey is only 17 years old, unless he started practicing before he was born in the womb, he should belong to the latter.

Being surpassed by a surgical genius, Herman had nothing to say.

The operation officially ended at 8:10 p.m., and Father Schmidt was sent back to the ward accompanied by nurses.Next, he still needs to face "resurrection" therapy [5], as well as long incision care work.

With such a long incision and prolonged hands-on work, airborne bacteria are sure to colonize the incision.

That is, Kavey, covered the incision with wet clean gauze in advance, and protected the incision, otherwise infection would definitely be the inevitable result.But even so, he did not dare to take it lightly, because he lacked wound disinfection equipment and antibiotics, so he could only rinse with plenty of water after suturing.

The operating area in the center has long been a fish stall in the port, and there is stagnant water everywhere.

But Ignatz, who was supposed to be held accountable, directly chose to ignore the cleft lip modification surgery sent by Kavey, and left the theater early after the interview.

And because Herman asked him for something, he just went about his work silently and chose not to say anything.

Only the "temporary worker" Varela, who was staying aside, couldn't help jumping out: "Dr. Carvey, I have to admit that your operation is very beautiful. But this still can't answer the question in my heart, why did you So keen on cleaning?"

"Because the air is full of miasma." Carvey said, "Nothing can block the miasma, so the only way to clean it is after the miasma falls."

This is quite reasonable, but there are still quite a few loopholes, and Varela can't let it go easily: "What about the salt? Why do you sprinkle salt into the water every time before cleaning the priest's stomach? Clean the sutures I also use salt when cooking, it’s not stewing thick soup, and it’s not making bacon, no need for seasoning.”

Varela's doubts are not alone.

As soon as he finished speaking, several viewers who were waiting to ask questions around Carvey also became interested: "We also find it strange that every time we get clean water, Dr. Carvey will sprinkle fine salt like eating steak."

At this time, "osmotic pressure" was still hidden in Van Hove's mind, and it hadn't taken root. It was impossible for Carvey to talk about such advanced knowledge of physics and chemistry to Varela, who only had a middle school education.He can only make a high profile first, and then use something else to whitewash his behavior.

"You say it's a condiment?"

Carvey frowned, looked them up and down, hesitated for a while before asking: "You are not Catholics, are you?"

"Of course I am." Varela took the lead in affirming his belief, but after thinking about it, he added, "This should be regarded as a family belief."

"We're all Austrians, of course."

"Then you should know what salt means to Father Schmidt!" If you want to kill your words, you have to give them a high-sounding reason, "White salt is a sacred symbol, and sprinkled with table salt is cleaning The sins left by the appendix and roundworms!"

"It was so"

"Dr. Carvey has a heart."

"The appendix hiding the roundworm was cut off, and the body was washed with salt water several times. God will surely forgive him the sin of operating without authorization."

Looking at their reactions, Carvey can only complain in his heart that the brainwashing effect is simply too good.Now he has a verbal offensive to make people stunned, and then he can start to output real opinions: "I think every abdominal surgery needs to be washed with salt water, and it is an appropriate amount of salt water wash!"

"What is the right amount?"

"Equivalent to our bodily fluids is the right amount."

"Equal? ​​Can equality have the effect of washing away sins?"

"The body that God bestows on us is an important power against sin. We are not qualified to change this power. That is a blasphemy against God!"

Carvey originally wanted to explain osmotic pressure with the help of Catholicism, but he had no understanding in this area. He just started and found that he couldn't make it up.But to his surprise, the effect of this rhetoric was surprisingly good.

"I see."

"Dr. Carvey has such surgical skills at such a young age, and is so devout. He is a model for us to learn from!"

"I have to declare that this is the most perfect combination of science and medicine since the birth of religion."

"It is indeed a brand-new attempt. You can even try to use pure salt to eliminate miasma!"

As soon as Kawei heard something wrong, he quickly corrected: "It is washing, it can only be regarded as driving away, not eliminating. The miasma is all around us, and it is a trial given to us by the Lord. It would be too ignorant to want to completely eliminate the miasma!"

"I see."

Beads of sweat oozed from Kawei's forehead: I'm so tired!

Although he exaggerated the saline solution so much that he almost said it was holy water from God, in fact the hypertonic environment brought about by table salt was useless to roundworms.Let alone adults, even roundworm eggs are not afraid of being saturated with salt water. 【6】

It's just that, Carvey can't control it.

At nine o'clock in the evening, he returned to the hospital.

After explaining some post-operative precautions to Little Schmidt, he asked Fernan for the address of the slaughterhouse, and then ran to the maternity ward.

The cesarean section was the springboard for him to become the chief surgeon. The operation was indeed beautiful, but it made him very worried after the operation.

The longitudinal incision of the classical cesarean section is longer than the transverse incision, and the recovery time must be correspondingly prolonged. Even if there is no infection, it will take seven days to leave the hospital.But as long as there is nothing wrong with the incision in the first three days after the operation, there will be no problem if you continue to follow the steps step by step.

Before the priest's appendix operation, Carvey had seen her wound, and there was no infection.After inquiring about Nora's normal bowel movements, the nurse asked the nurse to increase her diet to increase her nutrition and help her recover.

Now he needs to popularize the key points of breastfeeding and prevent mastitis. This is not only important to Nora, but also to her child.

Only after making sure that everything is safe can Carvey feel at ease.

But the problem he has been worrying about still came
"Excuse me, nurse, I want to ask, where is Nora in bed 24?"

　Another update (4/20), there is another update tonight, probably in the middle of the night, you can watch it tomorrow.

　　
　
(End of this chapter)